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投稿时间：2019-12-24 网络发布日期：2020-05-20
投稿时间：2019-12-24 网络发布日期：2020-05-20
中文摘要: 目的 探讨中老年人血清γ-谷氨酰转肽酶(GGT)水平与代谢表型之间的关系,旨在为该人群代谢综合征(MS)的临床预测提供新思路。方法 选取2016年1月至12月南京鼓楼医院体检中心体检的年龄≥40岁中老年3 289例,男性和女性均按有无MS分为MS组和非MS组。采用Spearman相关和Logistic回归分析MS危险因素,ROC曲线用于确定血清GGT预测MS最佳临界点。结果 研究总人群MS患病率为31.8%(1 046/3 289),其中男性为35.5%(921/2 598),女性为18.1%(125/691)。男性和女性MS组血清GGT水平均显著高于非MS组(P<0.01)。在男性和女性中,血清GGT与腰围、收缩压（SBP）、舒张压（DBP）、空腹血清葡萄糖（FPG）和甘油三酯（TG）均呈正相关(P<0.01),与高密度脂蛋白胆固醇（HDL-C）呈负相关(P<0.01);依据血清GGT水平由低到高的四分位数将中老年男性和女性各分成四组(Q1~Q4),在校正年龄、体质指数（BMI）、尿酸、肌酐、尿素氮、冠心病及非酒精性脂肪肝病史等混杂因素后,血清GGT仍是MS的独立危险因素［男性Q4组MS患病风险是Q1组5.569倍（95%CI:4.004～7.746）,女性Q4组MS患病风险是Q1组3.117倍（95%CI:1.322～7.350）］。男性血清GGT在28.5 U/L预测MS灵敏度为74.4%,特异度为64.2%;女性血清GGT在20.5 U/L预测MS灵敏度为72.0%,特异度为62.0%。结论 中老年人血清GGT升高是MS发生危险因素,其正常范围内的升高即已与MS患病增加相关,尤其是女性。
Abstract:ObjectiveTo investigate the relationship between serum gama-glutamyltransferase (GGT) level and metabolic phenotypes in the middle-aged and elderly population with metabolic syndrome (MS) to develop a new clinical prediction.MethodsA total of 3 289 participants aged 40 years or older were selected from physical examinees between January 2016 to December 2016 and were divided into non-MS group and MS group (2 598 males and 691 females).Spearman correlation and logistic regression were used to analyze the risk factors of MS,and receiver operating characteristic (ROC) curve was used to determine the optimal critical point of serum GGT for predicting MS.ResultsThe prevalence of MS was 31.8% (1 046/3 289) in the study population,35.5% (921/2 598) in men and 18.1% (125/691) in women.The serum GGT level in MS group was significantly higher than that in non-MS group (P<0.01).The serum GGT level was positively correlated with waist circumference,systolic blood pressure(SBP),diastolic blood pressure(DBP),serum levels of fasting plasma glucose(FPG),triglyceride(TG)(P＜0.01) and was negatively correlated with serum level of high density lipoprotein cholesterol(HDL-C)(P＜0.01) in both males and females.According to the quartile of serum GGT level from low to high,male and female subjects were divided into four groups (Q1-Q4),respectively,and after adjusting age,body mass index(BMI),serum uric acid,creatinine,urea nitrogen,history of coronary heart disease and non-alcoholic fatty liver,serum GGT level remained as independent risk factor of MS.The risk of MS in Q4 group was 5.569 times of that in Q1 group (95%CI:4.004-7.746) in men and 3.117 times of that in Q1 group (95%CI:1.322-7.350) in women.The sensitivity and specificity of predicting MS were 74.4% and 64.2% when GGT cutoff value was 28.5 U/L in male;and that were 72.0% and 62.0% when GGT cutoff value was 20.5 U/L in female.ConclusionsIncrease of serum GGT is a risk factor for MS in middle-aged and old people,and elevated serum GGT even within its normal rang is associated with the development of MS,especially in females.
keywords: Metabolic syndrome Gama-glutamyltranspeptidase Middle-aged and elderly population Gender Hypertension Hyperglycemia Dyslipidemia Abdominal obesity
文章编号： 中图分类号： 文献标志码：A
基金项目:国家自然科学基金面上项目(81770819);国家重点研发计划(2016YFC1304804);江苏省重点研发专项资金项目(BE2016606);南京市医药卫生科研课题(YKK18067)
| 作者 | 单位 |
| 仲颖1 | 1.南京大学医学院附属鼓楼医院内分泌科,江苏 南京210008； |
| 毕艳1 | 1.南京大学医学院附属鼓楼医院内分泌科,江苏 南京210008； |
| 冯文焕1 | 1.南京大学医学院附属鼓楼医院内分泌科,江苏 南京210008； |
| 周卫红2 | 2.南京大学医学院附属鼓楼医院健康管理中心,江苏 南京210008； |
| 王静2 | 2.南京大学医学院附属鼓楼医院健康管理中心,江苏 南京210008 |
引用文本：
仲颖,毕艳,冯文焕,等.血清GGT与中老年人群代谢综合征相关性分析[J].中国临床研究,2020,33(5):611-615.
仲颖,毕艳,冯文焕,等.血清GGT与中老年人群代谢综合征相关性分析[J].中国临床研究,2020,33(5):611-615.